Organization
HENRY FORD SEMI MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR OF PROVIDER AFFAIRS)
(313) 874-6764
Entity
Organization
Contact information
Practice address
21000 E 12 MILE RD, SUITE 105, SAINT CLAIR SHORES, MI 48081-1116
(586) 498-3606
(586) 498-3601
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
(800) 999-5829
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MI
207R00000X
Internal Medicine Physician
—
MI
208000000X
Pediatrics Physician
—
MI
261QU0200X
Urgent Care Clinic/Center
Primary
—
MI
363A00000X
Physician Assistant
—
MI
Other
Enumeration date
07/12/2013
Last updated
04/28/2026
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